Children and Families’ mental health during the first COVID-19 lockdown in Italy

Laura Ferraro, Caterina La Cascia, Marco Daino, Giada Tripoli, Giuseppe Maniaci, Crocettarachele Santorio, Fabio Seminerio, Rosa Lo Baido, Daniele La Barbera

Abstract


Background: This study aimed to screen a wide range of emotional and behavioural variables emerging during the first COVID-19 pandemic-lockdown in a sample of parents and children, residents in the southern part of Italy, and explore which variables could predict children’s wellbeing. We hypothesised that difficulties in adapting routines to pandemic restrictions, parents’ emotional wellbeing, and attitude towards the pandemic could influence the children’s behavioural attitudes.


Methods: 221 parents completed the survey and gave information about 246 children. Ad hoc questionnaires were created and then exploratory reduced in factors. Strengths and Difficulties Questionnaire (SDQ) for parents assessed positive and negative behavioural attitudes in children. Depression Anxiety Stress Scale (Italian DASS-21) scored depression, anxiety and stress in parents.


Results: Children presented higher emotional distress (Mean difference (Mdiff)=0.6, 95% C.I. 0.2, 0.9, p=0.013) and better prosocial behaviour (Mdiff=0.5, 95% C.I. 0.1, 0.9, p=0.011) than the Italian normative sample. Parents were more depressed than expected in the general population (Mdiff=1.0, 95% C.I. 0.3, 1.6, p=0.005). Having developed a morbid attachment to an adult (B=0.37, 95% CI 0.05, 0.69, p=0.024), a higher parental depression (B=0.1, 95% CI 0.02, 0.18, p=0.014), and children’s suffering from nightmares (B=0.35, 95% CI 0.03, 0.67, p=0.032) explained the 31.9% of the total variance in children’s emotional distress. Children’s anxiety was related to parents’ fear of the pandemic effects (r=0.32, p=0.001) and avoiding communicative approach (r=0.24, p=0.011).


Conclusion: The first lockdown determined emotional distress and regressive mechanisms in children in the contest of higher parental discomfort, fear of the infection and avoidant communication. Following parents’ indications, it could be helpful to provide families with informative and age-appropriate support.

Keywords


COVID-19; Children; Communication; Anxiety; Depression; Emotional distress; Parents; Regression.

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References


Bakioğlu, F., Korkmaz, O., & Ercan, H. (2020). Fear of COVID-19 and Positivity: Mediating Role of Intolerance of Uncertainty, Depression, Anxiety, and Stress. International Journal of Mental Health and Addiction, 1. https://doi.org/10.1007/s11469-020-00331-y

Benassi, E., Vallone, M., Camia, M., & Scorza, M. (2020). Women during the Covid-19 lockdown: more anxiety symptoms in women with children than without children and role of the resilience. Mediterranean Journal of Clinical Psychology, 8(3), 1–19. https://doi.org/10.6092/2282-1619/mjcp-2559

Bottesi, G., Ghisi, M., Altoè, G., Conforti, E., Melli, G., & Sica, C. (2015). The Italian version of the Depression Anxiety Stress Scales-21: Factor structure and psychometric properties on community and clinical samples. Comprehensive Psychiatry, 60, 170–181. https://doi.org/10.1016/j.comppsych.2015.04.005

Brazendale, K., Beets, M. W., Weaver, R. G., Pate, R. R., Turner-McGrievy, G. M., Kaczynski, A. T., Chandler, J. L., Bohnert, A., & von Hippel, P. T. (2017). Understanding differences between summer vs. school obesogenic behaviors of children: The structured days hypothesis. International Journal of Behavioral Nutrition and Physical Activity, 14(1). https://doi.org/10.1186/s12966-017-0555-2

Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. In The Lancet (Vol. 395, Issue 10227, pp. 912–920). Lancet Publishing Group. https://doi.org/10.1016/S0140-6736(20)30460-8

Bruno, G., Panzeri, A., Granziol, U., Alivernini, F., Chirico, A., Galli, F., Lucidi, F., Spoto, A., Vidotto, G., & Bertamini, M. (2020). The Italian COVID-19 Psychological Research Consortium (IT C19PRC): General Overview and Replication of the UK Study. Journal of Clinical Medicine, 10(1), 52. https://doi.org/10.3390/jcm10010052

Buzzi, C., Tucci, M., Ciprandi, R., Brambilla, I., Caimmi, S., Ciprandi, G., & Marseglia, G. L. (2020). The psycho-social effects of COVID-19 on Italian adolescents’ attitudes and behaviors. Italian Journal of Pediatrics, 46(1), 69. https://doi.org/10.1186/s13052-020-00833-4

Christ, G. H., & Christ, A. E. (2006). Current Approaches to Helping Children Cope with a Parent’s Terminal Illness. CA: A Cancer Journal for Clinicians, 56(4), 197–212. https://doi.org/10.3322/canjclin.56.4.197

Cusinato, M., Iannattone, S., Spoto, A., Poli, M., Moretti, C., Gatta, M., & Miscioscia, M. (2020). Stress, Resilience, and Well-Being in Italian Children and Their Parents during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 17(22), 8297. https://doi.org/10.3390/ijerph17228297

Dalton, L., Rapa, E., & Stein, A. (2020). Protecting the psychological health of children through effective communication about COVID-19. The Lancet Child and Adolescent Health, 4(5), 346–347. https://doi.org/10.1016/S2352-4642(20)30097-3

Dalton, L., Rapa, E., Ziebland, S., Rochat, T., Kelly, B., Hanington, L., Bland, R., Yousafzai, A., Stein, A., Betancourt, T., Bluebond-Langner, M., D’Souza, C., Fazel, M., Fredman-Stein, K., Harrop, E., Hochhauser, D., Kolucki, B., Lowney, A. C., Netsi, E., & Richter, L. (2019). Communication with children and adolescents about the diagnosis of a life-threatening condition in their parent. In The Lancet (Vol. 393, Issue 10176, pp. 1164–1176). Lancet Publishing Group. https://doi.org/10.1016/S0140-6736(18)33202-1

Del Boca, D., Oggero, N., Profeta, P., & Rossi, M. (2020). Women’s and men’s work, housework and childcare, before and during COVID-19. Review of Economics of the Household, 18(4), 1001–1017. https://doi.org/10.1007/s11150-020-09502-1

Delmastro, M., & Zamariola, G. (2020). Depressive symptoms in response to COVID-19 and lockdown: a cross-sectional study on the Italian population. Scientific Reports, 10(1), 1–10. https://doi.org/10.1038/s41598-020-79850-6

Deniz, M. E. (2021). Self-compassion, intolerance of uncertainty, fear of COVID-19, and well-being: A serial mediation investigation. Personality and Individual Differences, 177, 110824. https://doi.org/10.1016/j.paid.2021.110824

Deolmi, M., & Pisani, F. (2020). Psychological and psychiatric impact of COVID-19 pandemic among children and adolescents. Acta Bio-Medica : Atenei Parmensis, 91(4), e2020149. https://doi.org/10.23750/abm.v91i4.10870

Di Giorgio, E., Di Riso, D., Mioni, G., & Cellini, N. (2020). The interplay between mothers’ and children behavioral and psychological factors during COVID-19: an Italian study. European Child and Adolescent Psychiatry, 1, 3. https://doi.org/10.1007/s00787-020-01631-3

Edwards, M., & Davis, H. (1997). Counselling Children with Chronic Medical Conditions. Wiley-Blackwell.

Fegert, J. M., Vitiello, B., Plener, P. L., & Clemens, V. (2020). Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: A narrative review to highlight clinical and research needs in the acute phase and the long return to normality. In Child and Adolescent Psychiatry and Mental Health (Vol. 14, Issue 1, p. 20). BioMed Central. https://doi.org/10.1186/s13034-020-00329-3

Ferraro, L., La Cascia, C., Sanna, M., & La Barbera, D. (2020). What is this crown-wearing virus that wants to defeat the world? COVID-19, we little superheroes know how to beat you! Evidence Based Psychiatric Care, 6, 163–166. https://doi.org/10.36180/2421-4469-2020-28

Fioretti, C., Palladino, B. E., Nocentini, A., & Menesini, E. (2020). Positive and Negative Experiences of Living in COVID-19 Pandemic: Analysis of Italian Adolescents’ Narratives. Frontiers in Psychology, 11, 3011. https://doi.org/10.3389/fpsyg.2020.599531

Fiorillo, A., & Gorwood, P. (2020). The consequences of the COVID-19 pandemic on mental health and implications for clinical practice. European Psychiatry, 63(1). https://doi.org/10.1192/j.eurpsy.2020.35

Freeston, M., Tiplady, A., Mawn, L., Bottesi, G., & Thwaites, S. (2020). Towards a model of uncertainty distress in the context of Coronavirus (COVID-19). In Cognitive Behaviour Therapist (Vol. 13). Cambridge University Press. https://doi.org/10.1017/S1754470X2000029X

Frisone, F., Alibrandi, A., & Settineri, S. (2020). Problem gambling during Covid-19. Mediterranean Journal of Clinical Psychology, 8(3), 1–15. https://doi.org/10.6092/2282-1619/mjcp-2457

GOV.UK. (2020). Guidance for parents and carers on supporting children and young people’s mental health and wellbeing during the coronavirus (COVID-19) pandemic -.

https://www.gov.uk/government/publications/covid-19-guidance-on-supporting-children-and-young-peoples-mental-health-and-wellbeing/guidance-for-parents-and-carers-on-supporting-children-and-young-peoples-mental-health-and-wellbeing-during-the-coronavirus-c

Griffiths, J., & Woodyatt, A. (2020). Wuhan coronavirus: Thousands of cases confirmed as China goes into emergency mode. CNN. https://edition.cnn.com/2020/01/26/asia/wuhan-coronavirus-update-intl-hnk/index.html

Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., … Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497–506. https://doi.org/10.1016/S0140-6736(20)30183-5

IBM Corporation. (2017). IBM SPSS Statistics for Macintosh (25.0). Armonk.

Liang, Z., Delvecchio, E., Buratta, L., & Mazzeschi, C. (2020a). ``Ripple effect{’’}: Psychological responses and coping strategies of Italian children in different COVID-19 severity areas. REVISTA DE PSICOLOGIA CLINICA CON NINOS Y ADOLESCENTES, 7(3), 49–58. https://doi.org/10.21134/rpcna.2020.mon.2054

Liang, Z., Delvecchio, E., Buratta, L., & Mazzeschi, C. (2020b). “Ripple effect”: Psychological responses and coping strategies of Italian children in different COVID-19 severity areas. Revista de Psicología Clínica Con Niños y Adolescentes, 7(3), 2020–2069. https://doi.org/10.21134/rpcna.2020.mon.2054

Mantovani, S., Bove, C., Ferri, P., Manzoni, P., Cesa Bianchi, A., & Picca, M. (2021). Children ‘under lockdown’: voices, experiences, and resources during and after the COVID-19 emergency. Insights from a survey with children and families in the Lombardy region of Italy. European Early Childhood Education Research Journal, 1–16. https://doi.org/10.1080/1350293X.2021.1872673

Marchetti, D., Fontanesi, L., Mazza, C., Di Giandomenico, S., Roma, P., & Verrocchio, M. C. (2020). Parenting-Related Exhaustion During the Italian COVID-19 Lockdown. Journal of Pediatric Psychology, 45(10), 1114–1123. https://doi.org/10.1093/jpepsy/jsaa093

Marzocchi, G., Di Pietro, M., Vio, C., Bassi, E., Filoramo, G., & Salmaso, A. (2002). Il questionario SDQ per insegnanti (Strength and Difficulties Questionnaire): uno strumento di screening per difficoltà comportamentali ed emotive in età evolutiva. DIFFICOLTÀ DI APPRENDIMENTO, 8, 75–84. https://boa.unimib.it/handle/10281/2523

Mazza, C., Ricci, E., Marchetti, D., Fontanesi, L., Di Giandomenico, S., Verrocchio, M. C., & Roma, P. (2020). How Personality Relates to Distress in Parents during the Covid-19 Lockdown: The Mediating Role of Child’s Emotional and Behavioral Difficulties and the Moderating Effect of Living with Other People. International Journal of Environmental Research and Public Health, 17(17), 6236. https://doi.org/10.3390/ijerph17176236

Merlo, E. M., Stoian, A. P., Motofei, I. G., & Settineri, S. (2021). The Role of Suppression and the Maintenance of Euthymia in Clinical Settings. Frontiers in Psychology, 12, 1534.

https://doi.org/10.3389/fpsyg.2021.677811

Mertens, G., Gerritsen, L., Duijndam, S., Salemink, E., & Engelhard, I. M. (2020). Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020. Journal of Anxiety Disorders, 74. https://doi.org/10.1016/j.janxdis.2020.102258

Morelli, M., Cattelino, E., Baiocco, R., Trumello, C., Babore, A., Candelori, C., & Chirumbolo, A. (2020). Parents and Children During the COVID-19 Lockdown: The Influence of Parenting Distress and Parenting Self-Efficacy on Children’s Emotional Well-Being. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.584645

Moroianu, L. A., Moroianu, M., Toma, A., Barbu, R., Ardeleanu, V., & Nitoi, L. C. (2021). Psychopathology in Patients Diagnosed with Sars Cov 2: a Brief Report. Mediterranean Journal of Clinical Psychology, 9(1), 1–15. https://doi.org/10.6092/2282-1619/mjcp-2982

Orgilés, M., Morales, A., Delvecchio, E., Mazzeschi, C., & Espada, J. P. (2020). Immediate psychological effects of the COVID-19 quarantine in youth from Italy and Spain. PsyAr- Xiv Preprints. https://doi.org/10.31234/osf.io/qaz9w

Parlapani, E., Holeva, V., Nikopoulou, V. A., Sereslis, K., Athanasiadou, M., Godosidis, A., Stephanou, T., & Diakogiannis, I. (2020). Intolerance of Uncertainty and Loneliness in Older Adults During the COVID-19 Pandemic. Frontiers in Psychiatry, 11, 1. https://doi.org/10.3389/fpsyt.2020.00842

Pietrobelli, A., Pecoraro, L., Ferruzzi, A., Heo, M., Faith, M., Zoller, T., Antoniazzi, F., Piacentini, G., Fearnbach, S. N., & Heymsfield, S. B. (2020). Effects of COVID‐19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study. Obesity, 28(8), 1382–1385. https://doi.org/10.1002/oby.22861

Pisano, L., Galimi, D., & Cerniglia, L. (2020). A qualitative report on exploratory data on the possible emotional/behavioral correlates of Covid-19 lockdown in 4-10 years children in Italy. PsyAr- Xiv Preprints. https://doi.org/10.31234/osf.io/stwbn

Racine, N., Cooke, J. E., Eirich, R., Korczak, D. J., McArthur, B. A., & Madigan, S. (2020). Child and adolescent mental illness during COVID-19: A rapid review. In Psychiatry Research (Vol. 292). Elsevier Ireland Ltd. https://doi.org/10.1016/j.psychres.2020.113307

Rettie, H., & Daniels, J. (2020). Coping and Tolerance of Uncertainty: Predictors and Mediators of Mental Health During the COVID-19 Pandemic. American Psychologist, 76(3). https://doi.org/10.1037/amp0000710

Romero, E., López-Romero, L., Domínguez-álvarez, B., Villar, P., & Gómez-Fraguela, J. A. (2020). Testing the effects of covid-19 confinement in spanish children: The role of parents’ distress, emotional problems and specific parenting. International Journal of Environmental Research and Public Health, 17(19), 1–23. https://doi.org/10.3390/ijerph17196975

Satici, B., Saricali, M., Satici, S. A., & Griffiths, M. D. (2020). Intolerance of Uncertainty and Mental Wellbeing: Serial Mediation by Rumination and Fear of COVID-19. International Journal of Mental Health and Addiction, 1. https://doi.org/10.1007/s11469-020-00305-0

Segre, G., Campi, R., Scarpellini, F., Clavenna, A., Zanetti, M., & Bonati, M. (2020). Interviewing children: the impact of the COVID-19 quarantine on children’s changes in routine and psychological distress.  https://doi.org/10.21203/rs.3.rs-64515/v1

Sethi, B. A., Sethi, A., Ali, S., & Aamir, H. S. (2020). Impact of coronavirus disease (COVID-19) pandemic on health professionals. Pakistan Journal of Medical Sciences, 36(COVID19-S4), S6. https://doi.org/10.12669/pjms.36.COVID19-S4.2779

Settineri, S., & Merlo, E. M. (2020). Editorial: Fear of Contamination. Mediterranan Journal of Clinical Psychology, 8(1), 1–8. https://doi.org/10.6092/2282-1619/mjcp-2424

Smirni, P., Lavanco, G., & Smirni, D. (2020). Anxiety in Older Adolescents at the Time of COVID-19. Journal of Clinical Medicine, 9(10), 3064. https://doi.org/10.3390/jcm9103064

Smith, B. M., Twohy, A. J., & Smith, G. S. (2020). Psychological inflexibility and intolerance of uncertainty moderate the relationship between social isolation and mental health outcomes during COVID-19. Journal of Contextual Behavioral Science, 18, 162–174. https://doi.org/10.1016/j.jcbs.2020.09.005

Spinelli, M., Lionetti, F., Pastore, M., & Fasolo, M. (2020). Parents’ Stress and Children’s Psychological Problems in Families Facing the COVID-19 Outbreak in Italy. Frontiers in Psychology, 11(July), 1–7. https://doi.org/10.3389/fpsyg.2020.01713

StataCorp. (2017). Stata Statistical Software: Release 15 (No. 15). StataCorp LP.

Tanhan, A., Yavuz, K. F., Young, J. S., Nalbant, A., Arslan, G., Yıldırım, M., Ulusoy, S., Genç, E., Uğur, E., & Çiçek, İ. (2020). A proposed framework based on literature review of online contextual mental health services to enhance wellbeing and address psychopathology during covid-19. Electronic Journal of General Medicine, 17(6), 1–11. https://doi.org/10.29333/ejgm/8316

Wang, G., Zhang, Y., Zhao, J., Zhang, J., & Jiang, F. (2020). Mitigate the effects of home confinement on children during the COVID-19 outbreak. In The Lancet (Vol. 395, Issue 10228, pp. 945–947).

Lancet Publishing Group. https://doi.org/10.1016/S0140-6736(20)30547-X

WHO World Health Organization. (2020). Managing the COVID-19 infodemic: Promoting healthy behaviours and mitigating the harm from misinformation and disinformation.

https://www.who.int/news/item/23-09-2020-managing-the-covid-19-infodemic-promoting-healthy-behaviours-and-mitigating-the-harm-from-misinformation-and-disinformation

World Health Organization. (2020). WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. WHO. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020




DOI: https://doi.org/10.13129/2282-1619/mjcp-2984

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